Provider Information for 1356771844
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LUWANDA BOYER
Sex: Female
NPI: 1356771844
Last Updated: 2014-10-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1356771844 | ||||||||
| Enumeration Date | 2013-11-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1413 FIELD ST DETROIT, MI 48214-2321 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 1413 FIELD ST DETROIT, MI 48214-2321 United States Phone: 131-355-5555 | Fax: | ||||||||
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